title: Neuropathological and neuroradiological spectrum of pediatric malignant gliomas: correlation with outcome.
abstract: BACKGROUND
  The diagnostic accuracy and reproducibility for glioma histological diagnosis are suboptimal.
  
  
  OBJECTIVE
  To characterize radiological and histological features in pediatric malignant gliomas and to determine whether they had an impact on survival.
  
  
  METHODS
  We retrospectively reviewed a series of 96 pediatric malignant gliomas. All histological samples were blindly and independently reviewed and classified according to World Health Organization 2007 and Sainte-Anne classifications. Radiological features were reviewed independently. Statistical analyses were performed to investigate the relationship between clinical, radiological, and histological features and survival.
  
  
  RESULTS
  Cohort median age was 7.8 years; median follow-up was 4.8 years. Tumors involved cerebral hemispheres or basal ganglia in 82% of cases and brainstem in the remaining 18%. After histopathological review, low-grade gliomas and nonglial tumors were excluded (n = 27). The World Health Organization classification was not able to demonstrate differences between groups and patients survival. The Sainte-Anne classification identified a 3-year survival rate difference between the histological subgroups (oligodendroglioma A, oligodendroglioma B, malignant glioneuronal tumors, and glioblastomas; P = .02). The malignant glioneuronal tumor was the only glioma subtype with specific radiological features. Tumor location was significantly associated with 3-year survival rate (P = .005). Meningeal attachment was the only radiological criteria associated with longer survival (P = .02).
  
  
  CONCLUSIONS
  The Sainte-Anne classification was better able to distinguish pediatric malignant gliomas in terms of survival compared with the World Health Organization classification. In this series, neither of these 2 histological classifications provided a prognostic stratification of the patients.
authors.affiliation: Department of Neurosurgery, Hôpital Necker Enfants Malades, Université Paris Descartes, Paris, France. stephanie.puget@nck.aphp.fr
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Puget
authors.forename: Nathalie
authors.initials: N
authors.lastname: Boddaert
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Veillard
authors.forename: Mathew
authors.initials: M
authors.lastname: Garnett
authors.forename: Catherine
authors.initials: C
authors.lastname: Miquel
authors.forename: Felipe
authors.initials: F
authors.lastname: Andreiuolo
authors.forename: Christian
authors.initials: C
authors.lastname: Sainte-Rose
authors.forename: Thomas
authors.initials: T
authors.lastname: Roujeau
authors.forename: Federico
authors.initials: F
authors.lastname: DiRocco
authors.forename: Marie
authors.initials: M
authors.lastname: Bourgeois
authors.forename: Michel
authors.initials: M
authors.lastname: Zerah
authors.forename: François
authors.initials: F
authors.lastname: Doz
authors.forename: Jacques
authors.initials: J
authors.lastname: Grill
authors.forename: Pascale
authors.initials: P
authors.lastname: Varlet
mesh_terms: D000293:Adolescent; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002868:Chromosomal Proteins, Non-Histone / Q000378:metabolism; D004268:DNA-Binding Proteins / Q000378:metabolism; D005260:Female; D005910:Glioma / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019394:Ki-67 Antigen / Q000378:metabolism; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009419:Nerve Tissue Proteins / Q000378:metabolism; D011859:Radiography; D012044:Regression Analysis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D000071796:SMARCB1 Protein; D016019:Survival Analysis; D014157:Transcription Factors / Q000378:metabolism
chemical_list: D002868:Chromosomal Proteins, Non-Histone; D004268:DNA-Binding Proteins; D019394:Ki-67 Antigen; D009419:Nerve Tissue Proteins; D000071796:SMARCB1 Protein; C513266:SMARCB1 protein, human; D014157:Transcription Factors